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AVANI DALAL
NPI 1417510983
Family Medicine in Philadelphia, PA

Active since April 19, 2019PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
5501 OLD YORK RD, PHILADELPHIA, PA 19141(215) 456-7890 Get Directions Write a Review

NPPES record last updated: April 30, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 30, 2024, Jul 3, 2023, Dec 7, 2022 and 2 more (5 updates tracked since 2019).

About Avani Dalal NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AVANI DALAL (NPI 1417510983) is an individual family medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD476262) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, is affiliated with Albert Einstein Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1417510983
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameAVANI DALAL
Location Address5501 OLD YORK RDPhiladelphia, PA 19141-3098
Mailing Address5501 Old York RdPhiladelphia, PA 19141-3098
Phone(215) 456-7890
Sole ProprietorNo
Medical School CMSTemple University School Of MedicineGraduated 2019
Enumeration DateApril 19, 2019
Last NPPES UpdateApril 30, 20245 updates tracked since enumeration
NPPES CertifiedJuly 3, 2023
✔ NPI 1417510983 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in PA · MD476262✔ Licensed in CA · A178810✔ Licensed in PA · MT217491
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
5501 OLD YORK RD, Philadelphia, PA 19141
Open in Google Maps ↗

Secondary Practice Locations 2

Location 13600 Broadway Fl 4, Dept 43San Fransisco, CA 94611-2722 · Phone (510) 752-1000
Location 28815 Germantown Ave Fl 5Philadelphia, PA 19118-2722 · Phone (215) 248-8145

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Avani Dalal is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648686550
PECOS Enrollment IDI20230914002934
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
37 services25 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
14 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Albert Einstein Medical Center

Acute Care Hospitals · Philadelphia, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390142
Location5501 Old York RoadPhiladelphia, PA 19141 · Philadelphia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19141 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.23
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier14 claims14 services$67.82 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KENNETH KLECKNER MD
Emergency Medicine
5501 OLD YORK RD, EINSTEIN MEDICAL CENTER - PHILADELPHIA
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-6679
MS. AMMAN HASSAN MD
Pediatrics
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-3810
TAYLOR NICOLE THOMPSON PA-C
Physician Assistant (Medical)
5501 OLD YORK RD, KORMAN BUILDING SUITE 202
PHILADELPHIA, PA 19141
Philadelphia County (215) 254-2630
STEPHEN RYAN CHEN
Orthopaedic Surgery
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. DHRUV SHARMA MD
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
TIMOTHY DANIEL GARDNER DO
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. JONATHAN THOMAS LUCIANI DO
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
ASHIKA KAPOOR MD
Psychiatry & Neurology (Psychiatry)
5501 OLD YORK RD
PHILA, PA 19141
Philadelphia County (215) 456-8103

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Avani Dalal's NPI number?

The NPI number for Avani Dalal is 1417510983. It was assigned to this individual provider in the NPPES registry on April 19, 2019.

Where is Avani Dalal located?

Avani Dalal practices at 5501 Old York Rd, Philadelphia, PA 19141. The listed phone number is (215) 456-7890.

What is Avani Dalal's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Avani Dalal enrolled in Medicare?

Yes. Avani Dalal is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Avani Dalal accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Avani Dalal as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Avani Dalal affiliated with any hospitals?

According to CMS data, Avani Dalal is affiliated with Albert Einstein Medical Center.

When was this NPI record last updated?

The NPPES record for Avani Dalal was last updated on April 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.